Endocrinological Manifestations Research Articles

Leydig cell tumor of testis

In adult patients with Leydig cell tumor of the testis, endocrinologic signs occur in 30 per cent of the cases and often precede the onset of a palpable testicular mass. Gynecomastia is the most common endocrinologic manifestation and probably is due to increased estrogen secretion by the Leydig cells. In the patient with adrenogenital syndrome and testicular enlargement it is difficult to distinguish Leydig cell tumor from adrenal rest hypertrophy. Four patients with Leydig cell tumor and endocrinologic manifestations are discussed; three are adults who presented with gynecomastia and the fourth is a patient with congenital adrenogenital syndrome. In the adult patient inguinal orchiectomy is the treatment of choice, while in the patient with adrenogenital syndrome initial management by high-dose steroid suppression should be attempted prior to testicular exploration.

Textbook of Endocrinology

This new edition of Williams' endocrinology text is in fact a new book—and a much improved one. Previous chapters which conferred independent standing to the pineal body and to hormone effects on protein metabolism have been deleted and important new chapters have been added on the neurohypophysis, the endocrinologic manifestations of carcinoid tumors, and humoral manifestations of nonendocrine neoplasms. Ten of the 20 chapters have new authors or coauthors, and the roster of contributors includes absolutely first-rate people who have established and well-deserved reputations for excellence as investigators and educators. Every chapter has been extensively revised or rewritten. If it is no longer possible to publish a "complete textbook," ie, one which satisfies the earthy requirements of the clinician as well as the more rarefied demands of the basic scientist, nevertheless this book comes awfully close. It is remarkably current (eg, gonadotropin and thyrotropin immunoassay data are given), consistently thorough,

Eye signs in patients with Cushing's syndrome and pituitary tumors.

This report is concerned with eye signs in four patients having pituitary tumors associated with Cushing's Syndrome. All four patients had objective evidence of visual pathway compression at some time during their clinical course; two of the four patients developed bilateral extraocular movement palsies as a consequence of pituitary apoplexy. One patient displayed a unilateral proptosis. The chronological interrelationship between visual and endocrinological manifestations of the pituitary tumors in these four cases was variable.

Pantothenic acid deficiency in rats.

Pantothenic acid determination was performed in albino rats of the Wistar strain for the purpose of investigating the effect of the deficiency on the histology of various organs. With this intention, the animals were kept in a deficient state, and the levels of the vitamin in the blood, urine and a variety of organs were measured by microbioassay using Lactobacillus arabinosus. In the blood, bound and free values were measured respectively with a special reference. In addition, histological studies of various organs were carred out. The results obtained are as follows.1. Deficiency for 2 to 3 weeksAlthough there occurred a marked drop in the urinary value shortly after the experiment began, loss of weight and rusty coloration of the fur did not occur until 2 to 3 weeks, when urinary value reached roughly 1μg a day. The levels of the total as well as bound forms of the vitamin became extremely low by that time, the former being 43 (control, 615-650) and the latter 19 (control, 65-100)mμg/ml. Histological findings of the organs were practically similar to those of the deficiency group except for the adrenals which were in hypertrophic but hypofunctional state.2. Deficiency for 5 weeksIn this group, all the animals began to show more advanced changes and marked loss of weight. The levels of the vitamin in urine as well as in blood (total and bound) were reduced similarly to those in a deficiency state of 2 to 3 weeks' duration. However, the decrease was not so pronounced in all the animals. The endocrine glands showed more advanced changes than those in the deficiency state of 2 to 3 weeks' duration. The findings presented evidence to show the hypofunction of α-cells and the slight hyperfunction of β-cells of the hypophysis, hyperfunction of the thyroid, and a primary decrease of spermatogenesis. The adrenal cortex appeared to be hyperactive. These findings present the endocrinological manifestations due to the deficiency of the vitamin, which needs further study for elucidation. The changes of endocrine organs are not specific to the deficiency. However, it is reasonably assumed that the changes of endocrine organs together with the changes in the levels of the vitamin in urine, blood and organs may imply the important role of the endocrine glands in the manifestation of expeimental deficiency of the vitamin. Among the main organs, the changes in lungs seemed to explain the mechanism of the inflammatory process associated with the deficiency.3. Results in the recovery groupThe results in the recovery group were, as a whole, similar to those in the control, though the lowered levels of the bound form in the blood and adrenals and an enlarged adrenal cortex remain to be settled.4. Loading testUrinary elimination of the vitamin in the deficiency group after loading was similar to that of thiamine or riboflavin deficiency.

TESTICULAR DEFICIENCY: A CLINICAL AND PATHOLOGIC STUDY*†

SINCE the introduction into clinical medicine of the testicular biopsy by Hotchkiss (1) and by Charny (2) much progress has been made in elucidating the pathogenesis of various types of testicular deficiency. Some clinicians have been chiefly concerned with the problem of sterility (1, 2, 3, 4, 5, 6). Others have studied syndromes with endocrinologic manifestations, such as eunuchoidism (7, 8, 9), a testicular syndrome associated with gynecomastia (10, 11, 12), and the male “climacteric” (13, 14, 15). Nelson (16, 17) has made a general review of the subject of hypogonadism and more recently other general papers (18, 19, 20, 21, 22) have become available. The present study is an attempt to elucidate the various syndromes associated with testicular deficiency, from three angles: clinical status, testicular histology as determined by biopsy, and endocrinologic pattern as judged by hormonal assay. CLINICAL MATERIAL In the eight years up to 1947, at the Massachusetts General Hospital, each of 256 persons on on...